What Do I Do IF… COVID Decision Guide

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What Do I Do IF… COVID Decision Guide

1. When Should I Get Tested?

  • The most obvious time to get tested for COVID-19 is when you have noticeable symptoms
  • The Symptoms of COVID are: (note that many resemble conditions such as seasonal allergies,  the common cold and the flu…that’s one reason we strongly suggest getting the flu shot immediately!)
    • A cough
    • Sore throat
    • Minor congestion
    • Low-grade fever
    • Headache
    • Fatigue
    • Loss of taste or smell (mainly associated with the Delta variant)
  • If you were exposed to someone who has COVID-19, you should get tested whether or not you have symptoms yourself
  • This test should be done 3-5 days after exposure
  • CDC definition of close contact is being within 6 feet (2 meters) for a total of 15 minutes or more, over a 24-hour period.
  • Get tested between three and five days after traveling internationally regardless of your symptoms
  • If you’re traveling domestically
    • Fully vaccinated people should get tested only if they develop symptoms
    • Unvaccinated people should get tested three to five days after returning
  • Before attending gatherings:
    • You should use home tests or PCR tests before attending gatherings with people that you don’t live with, especially if you don’t know everyone’s vaccination or booster status

2. What Are The Different Tests?

  • Currently, there are two types of diagnostic tests
    • Molecular (RT-PCR) tests that detect the virus’s genetic material
  • These require testing by a laboratory service
  • This is the most accurate test option
  • Requires 1-3 days to get results.
  • The PCR test is not a test that we use after a COVID infection because it can stay positive for weeks to months
  • Antigen tests that detect specific proteins on the surface of the virus
    • These are the “home tests” that provide results immediately
    • Not as accurate as the PCR for initial diagnosis but, they have a very useful place in our COVID arsenal
    • Most accurate if you have symptoms of COVID
    • Results available in 15 minutes
    • If you do test positive with one of these tests, don’t be shy about repeating a few times over the next few days just to make sure
  • Samples are typically collected with a nasal or throat swab, or saliva collected by spitting into a tube.
  • Antibody tests look for antibodies that are made by the immune system in response to a threat, such as a specific virus
    • Antibodies can take several days or weeks to develop after you have an infection and may stay in your blood for several weeks after recovery.

3. What should you do if you or someone with whom you have been in close contact tests positive for coronavirus during the holidays?

  • Anyone with symptoms should get tested for COVID immediately and contact their healthcare provider
  • According to the CDC, COVID symptoms can appear anywhere from two to 14 days after someone is exposed to the virus
  • If I am Fully Vaccinated AND HAVE RECEIVED MY BOOSTER and am Asymptomatic:
    • If you have received your booster shot, you do not need to quarantine after exposure, but should wear a mask for 10 days following the exposure.
    • If symptoms do occur, the CDC stressed that you should immediately quarantine, until a negative test confirms that the symptoms are not due to COVID-19.
  • If I am Fully Vaccinated (but Without the Booster) and Asymptomatic:
    • Get a COVID test
    • Between five and seven days after their exposure
    • Start wearing a mask from the time of exposure for 14 days
    • If you get a negative test, then you can stop
    • If you get a positive test, then you need to quarantine for at least 10 days and
  • If you’re having symptoms, then you need to be symptom-free for at least 24 hours, after those 10 days
  • Can I go outside? Do I need to Isolate?
    • Once you’re exposed the most important thing is to make sure you don’t spread the virus to others
    • The CDC recommends that fully vaccinated individuals should isolate for 5 days after exposure and a positive test

– If you continue to have no symptoms after five days, the CDC states that you may leave isolation if you “continue to mask for five days to minimize the risk of infecting others.”

– If symptoms, such as a fever, are present, you should continue to stay home until your fever, or the other symptoms, resolve. If your symptoms resolve after five days, and you are without fever for 24 hours, the CDC said you are free to leave your house with a mask on.

– During isolation, assume that you’re infected and can spread the virus to others: it takes time for symptoms and tests to emerge as positive…you still can spread the virus to others before you feel ill or test positive.

– If you need to go out and get food or run to the drugstore, that’s fine but keep it to essential activities, not going out to the bar on Friday with friends

– If you are traveling home after a holiday visit, and are vaccinated and asymptomatic: you can do so by car with other vaccinated and asymptomatic people or by commercial transportation as long as you follow the masking requirements

– When you do go out, it’s essential to wear a mask to curb the potential that you might spread the virus to others…you should wear a higher-grade mask now that Omicron is so widespread but, at bare minimum, a surgical mask

  • What Do I Do If I Am Unvaccinated or Not Fully Vaccinated And Asymptomatic:
    • Get tested immediately when they are identified as a close contact.
    • Anyone, regardless of vaccination status, who tests positive for COVID-19 and is asymptomatic, should isolate themselves for at least five days..and be sure to always wear your mask
    • If you are exposed and unvaccinated, or not fully vaccinated, the CDC now recommends that you quarantine for five days, followed by “strict mask use” for five days after your quarantine. This guidance also applies to people who are more than six months out from their second mRNA dose of the vaccine — or more than two months out from their Johnson & Johnson Vaccine — but not yet been boosted.
  • What Do I Do If I am fully vaccinated, but still not eligible for a booster?
    • If you were fully vaccinated with either the Pfizer or the Moderna vaccine within the last six months, or you completed the primary series of the Johnson & Johnson vaccine within the last two months, the CDC said you do not need to be quarantined after exposure; however, you should still wear a mask for 10 days, following the exposure.

4. What To Do If Symptoms Develop?

  • Those who develop symptoms should get tested as soon as symptoms develop…and  check in with your health professional
  • If a test is negative and symptoms persist: another test might be needed a few days later, particularly for those who use at-home test kits just to be sure
    • If you’re having severe symptoms:
  • Call your doctor’s office and get their advice because:

– There are of course other things like the flu that are out there that can mimic COVID symptoms

– They may recommend that you receive Monoclonal Antibodies (see below)

  • If you’re having mild or lingering symptoms and your at-home test was negative:
    • Retest in three to five days…that’s why most of these kits actually come with two tests

5. What Should An Asymptomatic Person Do Who Tests Positive?

  • Globally, more than 40% of confirmed COVID-19 cases were asymptomatic — and we know that asymptomatic cases can still contribute to the spread of the virus
    • Get in contact with your health care provider
  • The Symptoms of COVID are: (note that many resemble conditions such as seasonal allergies,  the common cold and the flu…that’s one reason we strongly suggest getting the flu shot immediately!)
    • A cough
    • Sore throat
    • Minor congestion
    • Low-grade fever
    • Headache
    • Fatigue
    • Loss of taste or smell (mainly associated with the Delta variant)

6. When is Someone With COVID Contagious?

  • A person with COVID-19 is considered infectious starting two days before they develop symptoms, or two days before the date of their positive test if they do not have symptoms
    • The original variants had an incubation period of four to five days but with Omicron, it’s two to three days

7. Quarantine and Isolation: What Do I Need to Know?

  • What Is the difference between the two?
    • Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick
    • Isolation separates infected and sick people with a contagious disease from people who are not sick
  • Quarantine
    • Unvaccinated People:
  • Those who believe they have been in contact with someone who has COVID and are unvaccinated should quarantine
  • Those who have been within 6 feet of someone with COVID for a cumulative total of at least 15 minutes over a 24-hour period should stay home for 14 days after their last contact with that person and watch for symptoms

–  If possible, those quarantining should also stay away from the people they live with, particularly those who are at an increased risk of developing more severe COVID illness

–  If symptoms appear within the quarantine window, isolate immediately and contact a healthcare provider, the CDC’s guidance states

    • Vaccinated People:
  • Those who are fully vaccinated do not need to quarantine, according to the CDC, but they should get tested anywhere from five to seven days following their exposure regardless of symptoms
  • Isolation:
    • Those who test positive, regardless of vaccination status, must isolate, according to the CDC
  • People who are positive for COVID should stay home until it’s safe for them to be around others, including even other members of their home
    • To calculate your full 10 day isolation period, day 0 is your first day of symptoms. Day 1 is the first full day after your symptoms developed
    • If you test positive for COVID-19 and never develop symptoms, day 0 is the day of your positive viral test (based on the date you were tested) and day 1 is the first full day after your positive test. If you develop symptoms after testing positive, your 10-day isolation period must start over. Day 0 is your first day of symptoms. Day 1 is the first full day after your symptoms developed
  • Health officials recommend a “sick room” or area for those who are infected and a separate bathroom, if possible
    • That means you should stay in a separate room and use a separate bathroom from other people in your household, if possible, the CDC says
    • You should also wear a mask if you have to be around other people
    • Avoid sharing items (like cups and towels)
    • Avoid public transportation and generally avoid contact with other people
    • Monitor yourself for symptoms. You will likely get specific instructions from your doctor’s office about what to watch for, which might include things like taking your temperature every day
    • Tell your close contacts that you tested positive and they may have been exposed
  • When Can You Resume Contact With Others After Having COVID
    • If you had symptoms
      • The CDC says you can be around others if you meet the following criteria:
  • 10 days since symptoms first appeared and
  • 24 hours with no fever without the use of fever-reducing medications and
  • Other symptoms of COVID-19 are improving (note that loss of taste and smell may persist for weeks or months after recovery and do not count among these symptoms)
    • Note that these recommendations don’t apply to those who have severe COVID or weakened immune systems
  • For those with severe illnesses or weakened immune systems, the CDC says staying home up to 20 days after symptoms first appeared is advised, but people in this group should talk to their healthcare provider before making decisions.
  • People with weakened immune systems may require testing to determine when they can be around others
  • If you tested positive but had no symptoms for the duration of your isolation, the CDC says:
    • You can be with others after 10 days have passed since you had a positive viral test for COVID-19 (based on the date you were tested)

8. When Should You Call a Doctor?

  • When you have tested positive and have symptoms
  • The CDC urges those who have or may have COVID-19 to watch for emergency warning signs and seek medical care immediately if they experience symptoms including:
    • Trouble breathing
    • Persistent pain or pressure in the chest
    • New confusion
    • Inability to wake or stay awake
    • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

9. What Do I Do If My Child Under 5 Is Exposed to A COVID Positive Person

  • They do not need to see the doctor if there are no COVID symptoms
    • Your child should quarantine at home for 14 days and watch for symptoms
  • They do need to get a COVID-19 test
  • If needed, the CDC says that you can shorten your child’s quarantine to 10 days as long as your child shows no symptoms, or to 7 days if your child has a negative COVID-19 test on or after day 5

10. What About Monoclonal Antibodies?

  • Monoclonal antibodies are laboratory-produced molecules that act as substitute antibodies that can restore, enhance, or mimic the immune system’s attack on cells
  • For COVID, Monoclonal Antibody treatment is available to individuals with serious disease but they must be administered within five days of when you first started developing symptoms.
    • Test positive for COVID-19 (PCR or antigen test), AND:
    • Have had mild-moderate symptoms for 7 days or less (must still be symptomatic), AND:
    • Age ≥ 65 years OR
    • Age 12 years and older weighing at least 40 kg
    • Have at least one of the following: 
    • Overweight as defined by BMI > 25 kg/m2, or if age 12-17, have BMI ≥ 85th percentile for their age and gender based on CDC growth charts – Pregnancy -Chronic kidney disease – Cardiovascular disease (including congenital heart disease, hypertension) – Diabetes – Down syndrome – Dementia – Liver disease – Current or former smoker – Current or history of substance abuse – Immunosuppressive disease or immunosuppressive treatment  – History of stroke or cerebrovascular disease – Chronic lung disease – Sickle cell disease – Neurodevelopmental disorders (e.g., cerebral palsy) – Having a medical-related technological dependence (e.g., tracheostomy, gastrostomy) Post-exposure preventive monoclonal antibodies are available to those who have been exposed consistently with the CDC’s close contact criteria AND who are: -High risk for developing severe COVID-19 AND – Not fully vaccinated OR vaccinated but immunocompromised AND – 12 years of age or older (and at least 88 pounds)

Source:  BLACKDOCTOR.ORG/December 28, 2021.